<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Date')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-date" data-rule="required" class="form-control" name="row[date]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_count')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_count" data-rule="required" class="form-control" name="row[user_count]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ip_num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ip_num" data-rule="required" class="form-control" name="row[ip_num]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Hy_user_num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-hy_user_num" data-rule="required" class="form-control" name="row[hy_user_num]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Rechage_num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-rechage_num" data-rule="required" class="form-control" name="row[rechage_num]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Rechage_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-rechage_price" data-rule="required" class="form-control" step="0.01" name="row[rechage_price]" type="number">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
